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Published in: Journal of Anesthesia 1/2013

01-02-2013 | Clinical Report

Spinal cord stimulation for a woman with complex regional pain syndrome who wished to get pregnant

Authors: Shoji Ito, Takeshi Sugiura, Takafumi Azami, Hiroshi Sasano, Kazuya Sobue

Published in: Journal of Anesthesia | Issue 1/2013

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Abstract

A woman with complex regional pain syndrome (CRPS) in the right lower extremity who wished to discontinue medications to get pregnant underwent implantation of a spinal cord stimulation system (SCS). An electrode lead was placed at Th10–11 in the epidural space, accessed via the L2–3 interspace with a paramedian approach, and a pulse generator was implanted in the left buttock. She kept the SCS on 24 h a day. After she had experienced several chemical abortions, finally she got pregnant via artificial insemination. She had an uneventful delivery of a healthy baby by cesarean resection under spinal anesthesia. In a patient with CRPS who has an implanted SCS system and wishes to get pregnant, the electrode lead into the low thoracic epidural space should be accessed via the high lumbar intervertebral space in consideration of a future requirement for spinal or epidural anesthesia for cesarean section. The generator should be placed in the buttock to prevent impairment of the SCS system being caused by the enlarged abdomen during pregnancy. Although we were apprehensive of adverse effects owing to the electromagnetic field force and change of blood flow in the pelvic viscera, our patient had a successful delivery. SCS is a favorable option for patients with CRPS who wish to get pregnant.
Literature
1.
go back to reference Perez RS, Zollinger PE, Dijkstra PU, Thomassen-Hilgersom IL, Zuurmond WW, Rosenbrand KC, CRPS I task force. Evidence based guidelines for complex regional pain syndrome type 1. BMC Neurol. 2010;10:20–33.PubMedCrossRef Perez RS, Zollinger PE, Dijkstra PU, Thomassen-Hilgersom IL, Zuurmond WW, Rosenbrand KC, CRPS I task force. Evidence based guidelines for complex regional pain syndrome type 1. BMC Neurol. 2010;10:20–33.PubMedCrossRef
2.
go back to reference Kumar K, Rizvi S, Bnurs SB. Spinal cord stimulation is effective in management of complex regional pain syndrome I: fact or fiction. Neurosurgery. 2011;69:566–78.PubMedCrossRef Kumar K, Rizvi S, Bnurs SB. Spinal cord stimulation is effective in management of complex regional pain syndrome I: fact or fiction. Neurosurgery. 2011;69:566–78.PubMedCrossRef
3.
go back to reference Sharma A, Agarwal S, Broatch J, Raja SN. A web-based cross-sectional epidemiological survey of complex regional pain syndrome. Reg Anesth Pain Med. 2009;34:110–5.PubMedCrossRef Sharma A, Agarwal S, Broatch J, Raja SN. A web-based cross-sectional epidemiological survey of complex regional pain syndrome. Reg Anesth Pain Med. 2009;34:110–5.PubMedCrossRef
4.
go back to reference Boswell MV, Shah RV, Everett CR, Sehgal N, McKenzie Brown AM, Abdi S, Bowman RC 2nd, Deer TR, Datta S, Colson JD, Spillane WF, Smith HS, Lucas LF, Burton AW, Chopra P, Staats PS, Wasserman RA, Manchikanti L. Interventional techniques in the management of chronic spinal pain: evidence-based practice guidelines. Pain Phys. 2005;8:1–47. Boswell MV, Shah RV, Everett CR, Sehgal N, McKenzie Brown AM, Abdi S, Bowman RC 2nd, Deer TR, Datta S, Colson JD, Spillane WF, Smith HS, Lucas LF, Burton AW, Chopra P, Staats PS, Wasserman RA, Manchikanti L. Interventional techniques in the management of chronic spinal pain: evidence-based practice guidelines. Pain Phys. 2005;8:1–47.
5.
go back to reference Prager JP. What does the mechanism of spinal cord stimulation tell us about complex regional pain syndrome? Pain Med. 2010;11:1278–83.PubMedCrossRef Prager JP. What does the mechanism of spinal cord stimulation tell us about complex regional pain syndrome? Pain Med. 2010;11:1278–83.PubMedCrossRef
6.
go back to reference Li DK, Odouli R, Wi S, Janevic T, Golditch I, Bracken TD, Senior R, Rankin R, Iriye R. A population-based prospective cohort study of personal exposure to magnetic fields during pregnancy and the risk of miscarriage. Epidemiology. 2002;13:9–20.PubMedCrossRef Li DK, Odouli R, Wi S, Janevic T, Golditch I, Bracken TD, Senior R, Rankin R, Iriye R. A population-based prospective cohort study of personal exposure to magnetic fields during pregnancy and the risk of miscarriage. Epidemiology. 2002;13:9–20.PubMedCrossRef
7.
go back to reference Bracken MB, Belanger K, Hellenbrand K, Dlugosz L, Holford TR, McSharry JE, Addesso K, Leaderer B. Exposure to electromagnetic fields during pregnancy with emphasis on electrically heated beds: association with birthweight and intrauterine growth retardation. Epidemiology. 1995;6:263–70.PubMedCrossRef Bracken MB, Belanger K, Hellenbrand K, Dlugosz L, Holford TR, McSharry JE, Addesso K, Leaderer B. Exposure to electromagnetic fields during pregnancy with emphasis on electrically heated beds: association with birthweight and intrauterine growth retardation. Epidemiology. 1995;6:263–70.PubMedCrossRef
8.
go back to reference Segal R. Spinal cord stimulation, conception, pregnancy and labor: case study in a complex regional pain syndrome patient. Neuromodulation. 1999;2:41–5.PubMedCrossRef Segal R. Spinal cord stimulation, conception, pregnancy and labor: case study in a complex regional pain syndrome patient. Neuromodulation. 1999;2:41–5.PubMedCrossRef
9.
go back to reference Hanson JL, Goodman EJ. Labor epidural placement in a woman with a cervical spinal cord stimulator. Int J Obstet Anesth. 2006;15:246–9.PubMedCrossRef Hanson JL, Goodman EJ. Labor epidural placement in a woman with a cervical spinal cord stimulator. Int J Obstet Anesth. 2006;15:246–9.PubMedCrossRef
10.
go back to reference Saxena A, Eljamel MS. Spinal cord stimulation in the first two trimesters of pregnancy: case report and review of the literature. Neuromodulation. 2009;12:281–3.PubMedCrossRef Saxena A, Eljamel MS. Spinal cord stimulation in the first two trimesters of pregnancy: case report and review of the literature. Neuromodulation. 2009;12:281–3.PubMedCrossRef
11.
go back to reference Bernardini DJ, Pratt SD, Takoudes TC, Simopoulos TT. Spinal cord stimulation and the pregnant patient–specific considerations for management: a case series and review of the literature. Neuromodulation. 2010;13:270–4.PubMedCrossRef Bernardini DJ, Pratt SD, Takoudes TC, Simopoulos TT. Spinal cord stimulation and the pregnant patient–specific considerations for management: a case series and review of the literature. Neuromodulation. 2010;13:270–4.PubMedCrossRef
Metadata
Title
Spinal cord stimulation for a woman with complex regional pain syndrome who wished to get pregnant
Authors
Shoji Ito
Takeshi Sugiura
Takafumi Azami
Hiroshi Sasano
Kazuya Sobue
Publication date
01-02-2013
Publisher
Springer Japan
Published in
Journal of Anesthesia / Issue 1/2013
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI
https://doi.org/10.1007/s00540-012-1462-y

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